According to the worrying results of a recent study, around five per cent of patients who suffer with rheumatoid arthritis and who received outpatient therapy had cervical arthritis, and about half of those did not receive adequate treatment at diagnosis.
A team of researchers from Germany conducted a cervical screening chart review of 395 patients who have rheumatoid arthritis (RA) at an outpatient clinic over a period of three months. The results admitted that these patients partially overlapped with eight patients who underwent C1–C2 fusion for RA cervical involvement from an orthopaedic surgery department.
The charts for 67 patients (or 17 per cent) did not include reports on cervical spine X-ray films; these included 21 (eight percent) of 257 with disease duration of five years or more. 17 of the 347 RA patients (or five per cent of all outpatient patients with X-rays), however, had an atlantodental distance of more than 3 mm. Four other RA patients from the orthopaedic surgery department fusion cohort were added for a total of 21 patients with cervical arthritis. 12 of them did not have symptoms.
Erosive peripheral arthritis with at least 10 years of disease duration was indicated in all 21 patients who had cervical arthritis and all of them were found to be rheumatoid factor-positive. Around half of these patients were not under adequate therapy when cervical problem was diagnosed, and none were on biological response modifiers.
Despite some unusual therapeutic approaches, we have found cervical arthritis in approximately five per cent of patients with rheumatoid arthritis seen at the division’s outpatient clinic. More than two-thirds of those patients were free form symptoms and erosive seropositive rheumatoid factor with longer disease duration and inadequately controlled disease activity predicted increased risk.